Management of Patients Taking Oral Anticoagulants Who Need Urgent Surgery for Hip Fracture
Grandone E`., Ostuni A., Tiscia G. L., Marongiu F., Barcellona D.
Seminars in Thrombosis and Hemostasis
Vol.45, Issue2, P. 164-170
Опубликовано: 2019
Тип ресурса: Статья
DOI:10.1055/s-0039-1678718
Аннотация:
The number of hip fractures in anticoagulated patients is predicted to increase, due to people living longer. However, evidence regarding urgent perioperative management of elderly patients with hip fracture who take oral anticoagulants (vitamin K antagonists or direct oral anticoagulants) is scarce. In this article, the authors present a narrative review of the evidence to date supporting the urgent management of hip fracture in anticoagulated elderly patients. They discuss the complexity of managing the high risk of procedure-related bleeding and, at the same time, the high risk of thromboembolism. The role of a bridging procedure and the best strategy of anticoagulation reversal are also reviewed. Further studies are required to improve the evidence in urgent surgery, especially in frail elderly patients. © 2019 Georg Thieme. All rights reserved.
Ключевые слова:
aged; anticoagulants; emergencies; hemorrhage; hip fractures; venous thromboembolism
andexanet alfa; anticoagulant agent; antivitamin K; dabigatran; idarucizumab; protamine sulfate; prothrombin complex; tranexamic acid; warfarin; anticoagulant agent; vitamin K group; aged; anticoagulant therapy; Article; bleeding; Cochrane Library; comorbidity; Embase; emergency surgery; female; frail elderly; hip fracture; human; information retrieval; male; Medline; mortality rate; patient care; perioperative period; postoperative complication; priority journal; risk assessment; thromboembolism; thrombosis prevention; treatment withdrawal; venous thromboembolism; antagonists and inhibitors; bleeding; chemically induced; complication; hip fracture; oral drug administration; risk factor; venous thromboembolism; Administration, Oral; Aged; Anticoagulants; Hemorrhage; Hip Fractures; Humans; Risk Assessment; Risk Factors; Venous Thromboembolism; Vitamin K
Язык текста: Английский
ISSN: 1098-9064
Grandone E`. E`l`vira 1963-
Ostuni A.
Tiscia G. L.
Marongiu F.
Barcellona D.
Грандоне Э. Эльвира 1963-
Остюни А.
Тисcиа Г. Л.
Маронгиу Ф.
Барcеллона Д.
Management of Patients Taking Oral Anticoagulants Who Need Urgent Surgery for Hip Fracture
Текст визуальный непосредственный
Seminars in Thrombosis and Hemostasis
Thieme Medical Publishers
Vol.45, Issue2 P. 164-170
2019
Статья
aged anticoagulants emergencies hemorrhage hip fractures venous thromboembolism
andexanet alfa anticoagulant agent antivitamin K dabigatran idarucizumab protamine sulfate prothrombin complex tranexamic acid warfarin anticoagulant agent vitamin K group aged anticoagulant therapy Article bleeding Cochrane Library comorbidity Embase emergency surgery female frail elderly hip fracture human information retrieval male Medline mortality rate patient care perioperative period postoperative complication priority journal risk assessment thromboembolism thrombosis prevention treatment withdrawal venous thromboembolism antagonists and inhibitors bleeding chemically induced complication hip fracture oral drug administration risk factor venous thromboembolism Administration, Oral Aged Anticoagulants Hemorrhage Hip Fractures Humans Risk Assessment Risk Factors Venous Thromboembolism Vitamin K
The number of hip fractures in anticoagulated patients is predicted to increase, due to people living longer. However, evidence regarding urgent perioperative management of elderly patients with hip fracture who take oral anticoagulants (vitamin K antagonists or direct oral anticoagulants) is scarce. In this article, the authors present a narrative review of the evidence to date supporting the urgent management of hip fracture in anticoagulated elderly patients. They discuss the complexity of managing the high risk of procedure-related bleeding and, at the same time, the high risk of thromboembolism. The role of a bridging procedure and the best strategy of anticoagulation reversal are also reviewed. Further studies are required to improve the evidence in urgent surgery, especially in frail elderly patients. © 2019 Georg Thieme. All rights reserved.